What are the treatments for singultus (hiccups)?

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Last updated: April 16, 2025View editorial policy

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From the Guidelines

To cure hiccups, chlorpromazine, a phenothiazine, can be used to treat intractable hiccups, as mentioned in the study 1. This is based on the strongest and most recent evidence available, which suggests that chlorpromazine is effective in treating hiccups. The study 1 provides information on the use of chlorpromazine for treating nausea, vomiting, and intractable hiccups, making it a viable option for curing hiccups. Some key points to consider when using chlorpromazine for hiccups include:

  • The dosage and administration of chlorpromazine for hiccups
  • The potential side effects and interactions of chlorpromazine with other medications
  • The importance of monitoring patients who receive chlorpromazine for close clinical observation, cardiorespiratory monitoring, pulse oximetry, and/or an electrocardiogram. It is essential to note that while chlorpromazine can be used to treat hiccups, it is crucial to prioritize the patient's overall health and well-being, considering potential risks and benefits, as well as alternative treatment options. In cases where hiccups persist for more than 48 hours, it is recommended to seek medical attention to rule out any underlying medical conditions that may require treatment. Additionally, other methods like drinking a glass of cold water quickly, holding your breath for 10-20 seconds, breathing into a paper bag for a few minutes, or gargling with ice water can be tried before seeking medical attention. However, chlorpromazine remains a viable option for curing intractable hiccups, as supported by the study 1.

From the FDA Drug Label

Intractable Hiccups– 25 mg to 50 mg t.i.d. or q.i.d. If symptoms persist for 2 to 3 days, parenteral therapy is indicated. The recommended dosage of chlorpromazine for intractable hiccups is 25 mg to 50 mg taken three or four times a day. If symptoms persist for 2 to 3 days, parenteral therapy may be necessary 2.

From the Research

Curing Hiccups

  • There are several pharmacologic treatments that have been proposed for intractable and persistent hiccups, including chlorpromazine, which is the only drug approved by the US Food and Drug Administration for the treatment of hiccups 3.
  • Other pharmacologic agents that have been found to be successful in treating hiccups include:
    • Amitriptyline
    • Baclofen
    • Gabapentin
    • Haloperidol
    • Metoclopramide
    • Midazolam
    • Nifedipine
    • Nimodipine
    • Orphenadrine
    • Valproic acid 3
  • The choice of therapy should be specific to individual patients, taking into account their underlying comorbidities, etiology of hiccups, and the individual properties of the drugs 3

Treatment Efficacy

  • Baclofen, gabapentin, and metoclopramide were the only agents that were studied in a prospective manner, while only baclofen and metoclopramide were studied in randomized controlled trials 3
  • Currently, there is little evidence to support the use of one agent over another for the treatment of intractable and persistent hiccups 3

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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